'Western' Diet May Boost Stroke Risk

Eating more plant-based foods could help prevent damage

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HealthDay Reporter

THURSDAY, July 1, 2004 (HealthDayNews) -- Pay close attention to what's on your plate because it could influence your risk of stroke, a new study finds.

If you typically eat a so-called "Western" diet -- mainly red and processed meats, refined grains, full-fat dairy products, sweets and desserts -- you could be setting yourself up for trouble, the study suggests. But if your diet is rich in fruits, vegetables, fish, poultry and whole grains, it may help you prevent a brain attack.

"We found out that the industrialized, Western pattern increases people's risk of stroke," said study author Teresa T. Fung, an assistant professor of nutrition at Boston's Simmons College.

Add in other risk factors and the news gets worse. Risk of ischemic stroke -- when a blood clot blocks an artery or blood vessel in the brain -- was four times higher for smokers whose diets most closely resembled the Western diet compared to nonsmokers whose dietary habits strayed from that eating pattern.

Women with high blood pressure whose diets closely mimicked a Western-style pattern had a threefold risk of ischemic stroke compared to women who were not hypertensive and did not stick to the red meat-and-sweets regimen.

The authors say the study is novel because is examines overall eating patterns and their risk of stroke. Most studies simply look for an association between a particular nutrient or food and stroke risk.

Stroke is the third leading cause of death in the United States, affecting 700,000 Americans annually. While diet is believed to be a controllable risk factor for stroke, it appears many Americans aren't getting the message.

"There are factors we can change that could have an impact on long-term risk for vascular diseases, and particularly stroke," said Dr. Ralph Sacco, a spokesman for the American Heart Association (AHA) and professor of neurology and epidemiology at Columbia University in New York City.

The AHA already recommends that people eat a variety of fruits and vegetables, whole grains, fish, legumes, skinless poultry, and lean meats to reduce their risk for heart attack and stroke.

Diet studies can be difficult to do, experts say, because they rely heavily on people remembering what and how much they ate and reporting that information honestly. In this study, women filled out detailed questionnaires about their eating habits in 1984 and again every four years over a 14-year period.

Teasing out other risk factors such as smoking, obesity and high blood pressure also complicates the task of relating a person's diet to risk for stroke.

"The problem with studies like this is, how do you factor out the people who exercise; how do you factor out that individual risk factor?" says Dr. Fred Pescatore, a private practice physician specializing in nutritional medicine and author of the recently released book The Hamptons Diet.

While Pescatore might quibble about red meat, he wholeheartedly agrees that a diet of refined grains, sweets and desserts can lead to insulin resistance and, ultimately, increased risk for cardiovascular disease.

"Even if we can sit here and pick apart the study, there's no way the American [Western] diet is healthy for us," he insisted.

To assess eating patterns and stroke risk, Fung and her colleagues gathered dietary information on 71,768 women in the Nurses' Health Study, a national study begun in 1976. The authors identified two eating patterns -- a Western diet and a prudent diet.

Each nurse received a prudent score and a Western score based on what they were eating. For example, the prudent score reflected how closely their diet resembled that dietary pattern. The same was true for the Western diet. In each case, a higher score indicated a higher adherence to the particular pattern.

The women were ranked according to their scores and divided into two groups of five. Participants at the top of each quintile were those whose diets most closely resembled the Western and prudent diets, respectively. Those at the bottom of quintile of dietary pattern became the reference group.

Over the 14-year study period, there were 791 strokes, including 476 ischemic strokes (the most common type), 189 hemorrhagic (caused by a blood vessel rupturing on or neat the brain), and 126 unclassified strokes.

After adjusting for lifestyle and other stroke risk factors, women with the highest Western diet scores were at nearly double the risk of developing any type of stroke compared to those with the lowest scores for that diet. Similarly, risk of ischemic stroke was nearly double among women with the highest Western diet scores vs. those with the lowest.

More information

Visit the National Institute of Neurological Disorders and Stroke to learn more about preventing stroke.

SOURCES: Teresa T. Fung, Sc.D., assistant professor, nutrition, School of Health Studies, Simmons College, and adjunct professor, nutrition, Harvard School of Public Health, Boston; Ralph Sacco, M.D., spokesman, American Heart Association, and professor, neurology and epidemiology, Columbia University College of Physicians and Surgeons, New York City; Fred Pescatore, M.D., medical director, Partners in Integrative Medicine, New York City, and author, The Hamptons Diet; July 2, 2004, Stroke

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